2015-03-03T18:48:25ZIncluding Cost Analysis in a Framework for Evaluating Technology Use at Multidisciplinary Team Meetings in Healthcarehttp://hdl.handle.net/2262/73138
Including Cost Analysis in a Framework for Evaluating Technology Use at Multidisciplinary Team Meetings in Healthcare
KANE, BRIDGET THERESA
2014-01-01T00:00:00ZComparing the job satisfaction and intention to leave of different categories of health workers in Tanzania, Malawi, and South Africa.http://hdl.handle.net/2262/72739
Comparing the job satisfaction and intention to leave of different categories of health workers in Tanzania, Malawi, and South Africa.
NORMAND, CHARLES; THOMAS, STEPHEN DAVID
Background: Job satisfaction is an important determinant of health worker motivation, retention, and performance, all of which are critical to improving the functioning of health systems in low-and middle-income countries. A number of small-scale surveys have measured the job satisfaction and intention to leave of individual health worker cadres in different settings, but there are few multi-country and multi-cadre comparative studies.
Objective: The objective of this study was to compare the job satisfaction and intention to leave of different categories of health workers in Tanzania, Malawi, and South Africa.
Methods: We undertook a cross-sectional survey of a stratified cluster sample of 2,220 health workers, 564 from Tanzania, 939 from Malawi, and 717 from South Africa. Participants completed a self-administered questionnaire, which included demographic information, a 10-item job satisfaction scale, and one question on intention to leave. Multiple regression was used to identify significant predictors of job satisfaction and intention to leave.
Results: There were statistically significant differences in job satisfaction and intention to leave between the three countries. Approximately 52.1% of health workers in South Africa were satisfied with their jobs compared to 71% from Malawi and 82.6% from Tanzania (chi(2) = 140.3, p<0.001). 18.8% of health workers in Tanzania and 26.5% in Malawi indicated that they were actively seeking employment elsewhere, compared to 41.4% in South Africa (chi(2) = 83.5, p<0.001). The country differences were confirmed by multiple regression. The study also confirmed that job satisfaction is statistically related to intention to leave.
Conclusions: We have shown differences in the levels of job satisfaction and intention to leave between different groups of health workers from Tanzania, Malawi, and South Africa. Our results caution against generalising about the effectiveness of interventions in different contexts and highlight the need for less standardised and more targeted HRH strategies than has been practised to date.
PUBLISHED
2013-01-01T00:00:00ZA cycle of brain gain, waste and drain - a qualitative study of non-Eu migrant doctors in Irelandhttp://hdl.handle.net/2262/72473
A cycle of brain gain, waste and drain - a qualitative study of non-Eu migrant doctors in Ireland
TYRRELL, ELLA; THOMAS, STEPHEN DAVID; NORMAND, CHARLES
Background
Ireland is heavily reliant on non-EU migrant health workers to staff its health system. Shortages of locally trained health workers and policies which facilitate health worker migration have contributed to this trend. This paper provides insight into the experiences of non-EU migrant doctors in the Irish health workforce.
Method
In-depth interviews were conducted with 37 non-EU migrant doctors in Ireland in 2011/2012.
Results
Respondents believed they had been recruited to fill junior hospital doctor ‘service’ posts. These posts are unpopular with locally trained doctors due to the limited career progression they provide. Respondents felt that their hopes for career progression and postgraduate training in Ireland had gone unrealised and that they were becoming de-skilled. As a result, most respondents were actively considering onward migration from Ireland.
Discussion & conclusions
Failure to align the expectations of non-EU migrant doctors with the requirements of the health system has resulted in considerable frustration and a cycle of brain gain, waste and drain. The underlying reasons for high mobility into and out of the Irish medical workforce must be addressed if this cycle is to be broken. The heavy reliance on non-EU migrant doctors to staff the medical workforce has distracted from the underlying workforce challenges facing the Irish medical workforce.
PUBLISHED
2013-01-01T00:00:00ZProblem alcohol use among problem drug users in primary care: a qualitative study of what patients think about screening and treatmenthttp://hdl.handle.net/2262/72464
Problem alcohol use among problem drug users in primary care: a qualitative study of what patients think about screening and treatment
SMYTH, BOBBY
Background: Problem alcohol use is common and associated with considerable adverse outcomes among patients who attend primary care in Ireland and other European countries for opiate substitution treatment. This paper aims to describe patients' experience of, and attitude towards, screening and therapeutic interventions for problem alcohol use in primary care. Methods. This qualitative study recruited problem drug users (N = 28) from primary care based methadone programmes in the Ireland's Eastern region, using a stratified sampling matrix to include size of general practice and geographical area. Semi-structured interviews were conducted and analysed using thematic analysis, and audited by a third reviewer. Results: We identified three overarching themes relevant to the purpose of this paper: (1) patients' experience of, and (2) attitude towards, screening and treatment for problem alcohol use in primary care, as well as their (3) views on service improvement. While most patients reported being screened for problem alcohol use at initial assessment, few recalled routine screening or treatment. Among the barriers and enablers to screening and treatment, patients highlighted the importance of the practitioner-patient relationship in helping them address the issue. Nevertheless, patients felt that healthcare professionals should be more proactive in the management of problem alcohol use at a primary care level and that primary care can play an important role in their treatment. Conclusions: Problem alcohol use is an important challenge in the care of problem drug users. While primary care is well placed to address this issue, little data has reported on this topic. The development of interventions which promote screening and brief interventions in practice are likely to benefit this at-risk group and further research and education, that help achieve this goal, are a priority. Strategies such as dissemination of clinical guidelines, educational videos, academic detailing and practice visits, should be explored
PUBLISHED
2013-01-01T00:00:00Z